From the Corner Office

Keeping the Nitty Gritty in Focus Without Losing the Big Picture

By Association Adviser staff • November 13, 2014

Rita Chen Fujisawa
Rita Chen Fujisawa, California Association of Health Facilities

This month’s Corner Office spotlight focuses on Rita Chen Fujisawa, chief operating officer of the California Association of Health Facilities (CAHF), which represents more than 1,300 skilled nursing facilities statewide.





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Nursing homes often get negative publicity, but I get to see all the great work they do and tremendous care they provide residents.

Our members are not early adopters of technology, but the health care landscape is changing so dramatically, they need to change many of their business models and best practices to keep up.

Association Adviser: What do you enjoy most about working in the association world?

Rita Chen Fujisawa: I love it. I can’t think of any other place where you get to wear so many different hats—technology, finance, operations, policy objectives, human resources and content. I have a hand in everything. It’s not just internal operations, but strategy. I get deep in the weeds, but I also get to see the big picture. There’s no other type of job where you get to understand the depth of a profession—the ins and outs, the struggles they face and the challenges they must overcome to be successful. For example, nursing homes get a lot of negative press, but I get to see all the great care that’s being provided to the elderly.

AA: What’s on members’ minds these days?

RCF: Our members are business owners. They represent the nursing home segment. Their biggest challenge is staying in business. How do they provide 24-hour care and on top of that, [deal with] all the other regulations they have to follow? They’re constantly being audited. The idea is to get everyone in Medicare and Medi-Cal enrolled in managed care. But now each county has its own health plan. It could be up to five health plans per county and each plan wants to delegate risk to another facility. That’s causing a lot of confusion for our members, not to mention a cash flow crunch.

AA: How is CAHF helping?

RCF: We’re providing best practices about managed care, because this is a new landscape. They do need to change their business model and some of their best practices. Long-term care has more metrics-based performance measures and indicators and also affects how they will be paid. They will have to change many of their internal operations and processes to accommodate that. In addition to education [of members], there is heavy advocacy and education of our legislators about what nursing homes are facing and understanding that there are different levels of care. Many times nursing homes are confused with assisted living facilities and lumped all together. But, nursing homes and assisted living facilities have very different cost structures, levels of care and desired outcomes for their residents.

AA: Speaking of evolving, can you tell us more about your involvement with the ASAE Innovation Grant Program?

RCF: Sure. I was part of the original steering committee to figure it out. We created it from scratch about three years ago with the help of SunTrust Bank. SunTrust gives us $40,000 a year to make up to four awards of $10,000 each to deserving innovators in the association community. The idea is to help recipients dive deeper into innovation and get support to implement their project ideas. We want the whole association community to learn from them. I look at a LOT of proposals and really enjoy evaluating them.

AA: So you’re really on the bleeding edge of association technology?

RCF: Not necessarily. Remember, technology is not necessarily innovation, and vice versa. Innovation could be a new process or approach to solving a problem that we want to reward, not necessarily technology. Also, developing an app isn’t innovative per se, unless it’s in an industry that’s not very tech savvy.

AA: How would you describe your leadership style?

RCF: I try to lead by example. I don’t like being the instructor, telling people to do it this way or that way. I’m not a black-and-white person. I want people to figure things out for themselves. I’m the No. 2 person to our CEO. My job is to make every one of our 35 employees look good. My job is to make them successful. I’m here to coach, guide and mentor them.

AA: So how do you foster a culture of innovation at CAHF?

RCF: You’ve got to balance risk management with the greater good. One of the nice things about CAHF is that we don’t have much employee turnover. But, one of challenges at CAHF is that we don’t have much employee turnover. Everyone’s been here a long time. It makes it harder to innovate and think outside the box. You get a lot of “we tried it before and it didn’t work.” My response is always to ask why it didn’t work last time. Did you ever consider doing it this way? I love to brainstorm. You need to show you are excited about what’s going on and recognize success. You have to take the boundaries away.

AA: How is technology helping members?

RCF: Quality measures are very big in our industry for holding facilities and skilled nurses accountable. There’s a lot of data out there and that’s where technology comes in. How do you tie it all together? How do you benchmark against other facilities in terms of say, percentage of readmissions back to a hospital, resident activities per day, or percentage of times using psychiatric drugs or restraints? Those are all quality indicators that our members monitor closely. Many of our vendors are offering members cutting-edge technologies to help nursing homes need to get up to speed with the metrics that they need to measure. We work with our vendors to provide education about the types of software and technology that’s out there for our members. Technology plays a big role in [the future of] long-term care, for instance, electronic medical records to document the care that’s provided to residents of nursing homes.

AA: How has CAHF’s social media evolved?

RCF: I’m now hiring people with social media experience. When I first got here, everyone said we need to be on Facebook, Instagram and Twitter. But I said, “Let’s not just be on it to be on it. We need to understand what members are using. What’s our strategy? What’s our message? We can’t be on all the platforms at the same time. It needs to be an integrated strategy.” We weren’t tracking any data at the time. Now we are—month to month and issue to issue [if a publication]. With our social media audit, we’re identifying the standards of how we measure, but also what the social media tools are that best fit with our organization. Again, our members are generally late adopters of technology. We need to educate them about getting valuable information online.

Watch Rita Fujisawa discuss how CAHF meets the information needs of its late-adopter membership while continuing to innovate its communications.

AA: How has technology played a role in member education and professional development?

RCF: Professional development is very important to our members, mainly because many of them have licenses and are required to show a certain number of hours of continuing education. Professional development keeps them on top of the best ways to care for residents. We’re also looking at other formats so we can provide education and training in a more accessible way. For instance, we’re looking at learning management systems, and providing education and training online and on-demand. Our members and their staffs are so busy; it’s very hard to draw them to our conferences. It’s very hard to allow the whole staff to come to conferences at one time. Online learning will be our direction.

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